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Dutch hospitals count mistakes

7th May 2007

A recent investigation into mistakes made by hospitals in the Netherlands has shown that around 1,700 avoidable deaths occur in hospitals annually as a result of treatment.

heart surgery

The independent investigation was launched by the Order of Medical Specialists, the Dutch hospital consultants' body, and found that a further 30,000 hospital patients in the Netherlands suffered avoidable harm during treatment.

With the cooperation of a cross section of the country's hospitals and the collaboration of the Institute for Health Services Research, and Amsterdam's Free University Medical Centre, the report showed that 5.7% of 1.3 million hospital admissions in 2004 resulted in harm to the patient.

This compares with rates of between 2.9% and 16.6% elsewhere in the world, according to US figures.

Pieter Vierhout, surgeon and chairman of the consultants' group, said that the Netherlands might compare favourably with other countries in terms of safety but that "every avoidable death or patient harmed is one too many."

About 40% of the adverse events reported in the Netherlands were avoidable, the report said. About 6,000 patients a year suffered some form of permanent harm as a result of the adverse events.

Researchers had access to 8,000 patients' files in 21 Dutch hospitals (about a quarter of the total), including a range of university, specialist clinical, and general units. More than 120 nurses and hospital consultants studied the files to identify clues such as unexpected deaths and readmissions and to judge whether harm could have been avoided.

Examples of adverse events included postoperative bleeding requiring further surgery and unexpected allergic reactions to treatment. Avoidable adverse events included drug treatment errors on discharge from hospital that resulted in the patient's readmission and failure to diagnose a leaking suture after abdominal surgery, leading to sepsis and death.

While adverse events often result from the complexities of modern care, especially care of elderly patients, deaths were often the result of largely preventable mistakes in diagnosis.

In some situations harm was definitely the result of 'unsatisfactory treatment', researchers said, recommending the introduction of real time monitoring of outcomes; systematic analysis of all deaths by consultants from a range of different specialties; identification of weak departments by medical staff and hospital boards; and standardisation of electronic patients' records.

Vierhout said the Netherlands could become an examplar of good practice within Europe, but he said first there needed to be "a cultural change within our hospitals - we need to be more critical and more disciplined."

The government plans to launch an action plan to improve hospital safety in June.

 

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